Healthcare Provider Details

I. General information

NPI: 1407962053
Provider Name (Legal Business Name): JORGE ROJAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 12/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2571 HENRY GOWER RD
PLEASANT VIEW TN
37146-9067
US

IV. Provider business mailing address

2571 HENRY GOWER RD
PLEASANT VIEW TN
37146-9067
US

V. Phone/Fax

Practice location:
  • Phone: 615-746-4308
  • Fax: 615-746-0928
Mailing address:
  • Phone: 615-746-4308
  • Fax: 615-746-0928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number11129
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: